Ultrasound and Clinical Approach for the Dynamic Assessment of Fluid Tolerance in the Intensive Care Unit - Trial NCT06415916

Timeline & Enrollment

Primary Outcome

the variation in the VExUs score during passive leg raising

Summary

A major cause of admission to intensive care is acute circulatory failure resulting from
 organ hypoperfusion due to factors such as hypotension and myocardial dysfunction. The
 standard treatment, including volume expansion and vasopressor/inotropic agents, often leads
 to water and sodium overload, increasing the risk of morbidity and mortality in the ICU. The
 combination of this overload and myocardial dysfunction lead to venous congestion,
 particularly affecting the lungs, kidneys and gastrointestinal system. Effective fluid
 management is therefore crucial to maintain a balance between adequate tissue perfusion and
 prevention of fluid overload. Fluid tolerance, defined as a patient's ability to tolerate
 additional volumes of solutes without adverse effects, is assessed retrospectively by
 clinical signs (capillary refill time, oedema, hepatojugular reflux, etc.) and ultrasound
 scores (VExUS score, LUS score, etc.). However, these indicators do not fully reflect the
 complexity of venous congestion in patients with various conditions.
 
 Assessing fluid tolerance remains a challenge in clinical practice. It requires a
 personalised approach and the use of dynamic tests such as passive leg raising to predict
 response to vascular filling. Despite their common use, there are no studies evaluating the
 ability of changes in congestion markers during passive leg raising to predict fluid
 tolerance.
 
 In conclusion, the main hypothesis is that changes in ultrasound congestion parameters (VExUS
 score, LUS score and others) during passive leg raising could predict a patient's subsequent
 tolerance to volume expander.

ICD-10 Classifications